DR. KEONDRA MARTINIQUE RUSTAN PMHNP-DNP, PH.D
NPI 1699495929
Nurse Practitioner - Psychiatric/Mental Health in Seattle, WA
About Dr. Keondra Martinique Rustan Pmhnp-dnp, Ph.d NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KEONDRA MARTINIQUE RUSTAN PMHNP-DNP, PH.D (NPI 1699495929) is an individual psychiatric/mental health provider in Seattle, Washington, licensed in Washington (ARNP.AP.70007587-NP) and active in the NPI registry since August 2022. She has opted out of Medicare through August 5, 2027 and maintains a secondary practice location in Lynnwood.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Keondra Martinique Rustan Pmhnp-dnp, Ph.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 5, 2025 through August 5, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98144 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Keondra Rustan's NPI number?
The NPI number for Keondra Rustan is 1699495929. It was assigned to this individual provider in the NPPES registry on August 29, 2022.
Where is Keondra Rustan located?
Keondra Rustan practices at 1600 S Lane St, Seattle, WA 98144. The listed phone number is (206) 682-2371.
What is Keondra Rustan's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Keondra Rustan enrolled in Medicare?
No. Keondra Rustan has opted out of Medicare through August 5, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
What insurance does Keondra Rustan accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Keondra Rustan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Keondra Rustan was last updated on August 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.
